ZINC AND COPPER EXCRETION AND ABSORPTION IN INFANTS WITH OSTOMIES

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 我们建议检查锌和铜的吸收和排泄的婴儿与造口术。这将通过测量锌、铜和血浆铜蓝蛋白的基线排泄和血清水平，以及通过利用锌和铜的稳定同位素测量吸收和排泄来实现。当造口术婴儿主要接受全肠外营养（TPN），很少或没有肠内喂养时，我们将收集24小时造口术排出物以测量锌和铜排泄，并测量血清锌、铜和铜蓝蛋白水平。我们将在两个时间点使用锌和铜的稳定同位素：当婴儿仍然有造口术并主要接受肠内营养而不接受TPN时，最后，当/如果患者的造口术被移除，肠道重新吻合，并且患者在肠内喂养方面稳定时。 对于研究的第一部分，将获得造口患者的锌排泄数据。 我们假设，与健康的足月儿或早产儿相比，有造口术的婴儿在粪便中排出更多的锌。 对于研究的第二部分，我们将通过使用稳定同位素获得锌吸收、分泌和排泄的数据。Jalla等人确定，健康婴儿的锌含量为0.4 mg/天。我们假设，由于锌损失增加，研究中的婴儿将比Jalla等人研究中的健康婴儿阳性率低。我们的研究旨在检测造口术患者的净潴留是否为Jalla描述的一半（即0.2 mg/d）。我们还将在研究的第二部分中通过使用稳定同位素获得关于铜吸收、分泌和排泄的数据。作为一项试点研究，我们并不完全知道造口婴儿的铜水平，但我们假设他们可能比没有造口的健康婴儿更不积极。此外，我们假设锌和铜在肠道中竞争性吸收;因此，接受更多锌的婴儿可能吸收较少的铜。 对于研究的第三部分，我们将通过使用稳定同位素获得婴儿手术后肠道再吻合的锌吸收数据。我们假设，可能有持续的锌损失高于那些记录的健康婴儿谁从来没有做过造口术，但减少损失相比，当婴儿有造口术。 确定回肠造口的存在如何影响婴儿在三个时间点的锌和铜代谢：1）婴儿进行造口并接受来自全肠外营养（TPN）的大部分热量时; 2）婴儿进行造口并主要接受肠内营养（不含TPN）时;以及3）当/如果婴儿进行了重新连接肠的手术并且主要接受肠内营养时。 本研究的主要目的围绕第2部分，锌和铜的吸收，分泌和排泄的婴儿造口术的稳定同位素部分。目前尚无该人群的锌平衡数据。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We propose to examine the absorption and excretion of zinc and copper in infants with ostomies. This will be accomplished by measuring baseline excretion and serum levels of zinc, copper, and ceruloplasmin, and by utilizing stable isotopes of zinc and copper to measure absorption and excretion. When an infant with an ostomy is receiving primarily total parenteral nutrition (TPN) with minimal or no enteral feeds, we will collect ostomy output for 24 hours to measure zinc and copper excretion, and will measure serum zinc, copper, and ceruloplasmin levels. We will utilize stable isotopes of zinc and copper at two time points: when the infant still has the ostomy and is receiving primarily enteral nutrition without TPN, and lastly, when/if the patient s ostomy is removed with the bowels reanastamosed and the patient is stable on enteral feeds. For the first part of the study, excretion data for zinc will be obtained for ostomy patients. We hypothesize that infants with an ostomy will excrete more zinc in their stools than healthy term or preterm infants without ostomies. For the second part of the study, we will obtain data on zinc absorption, secretion, and excretion through use of stable isotopes. Jalla et al determined that healthy infants retain zinc of 0.4 mg/day. We hypothesize that due to increased zinc losses, the infants in the study will be less positive than the healthy infants in the study by Jalla et al. Our study is designed to be able to detect if the ostomy patients net retention is one-half that described by Jalla (i.e. 0.2 mg/d). We will also obtain data on copper absorption, secretion, and excretion through the use of stable isotopes in the second part of the study. As a pilot study, we do not fully know what to expect regarding copper levels in infants with ostomies, but we hypothesize that they may be less positive than healthy infants without ostomies. Also, we hypothesize that zinc and copper are competitively absorbed in the gut; therefore, infants who receive more zinc may absorb less copper. For the third part of the study, we will obtain data on zinc absorption through the use of stable isotopes after the infant has had surgery to reanastamose the bowel. We hypothesize that there may be continued zinc losses above those documented for healthy infants who have never had an ostomy, but decreased losses compared to when the infant had an ostomy. To determine how the presence of an ileostomy impacts zinc and copper metabolism in infants at three time points: 1) when the infant has an ostomy and is receiving the majority of calories from total parenteral nutrition (TPN); 2) when the infant has an ostomy and is receiving primarily enteral nutrition without TPN; and 3) when/if the infant has a surgery to reconnect the bowel and is receiving primarily enteral nutrition. The primary objective of this study revolves around part 2, the stable isotope portion of zinc and copper absorption, secretion, and excretion in infants with an ostomy. There is currently no data available in this population for zinc balance.